评估冲突环境下性暴力受害者的心理支持：来自刚果布拉柴维尔的结果。
Evaluation of psychological support for victims of sexual violence in a conflict setting: results from Brazzaville, Congo.
机构信息
Epicentre, Paris, France.
出版信息
Int J Ment Health Syst. 2009 Apr 1;3(1):7. doi: 10.1186/1752-4458-3-7.
BACKGROUND
Little is known about the impact of psychological support in war and transcultural contexts and in particular, whether there are lasting benefits. Here, we present an evaluation of the late effect of post-rape psychological support provided to women in Brazzaville, Republic of Congo.
METHODS
Women who attended the Médecins Sans Frontières program for sexual violence in Brazzaville during the conflict were selected to evaluate the psychological consequences of rape and the late effect of post-rape psychological support. A total of 178 patients met the eligibility criteria: 1) Women aged more than 15 years; 2) raped by unknown person(s) wearing military clothes; 3) admitted to the program between the 1/1/2002 and the 30/4/2003; and 4) living in Brazzaville.
RESULTS
The initial diagnosis according to DSM criteria showed a predominance of anxious disorders (54.1%) and acute stress disorders (24.6%). One to two years after the initial psychological care, 64 women were evaluated using the Trauma Screening Questionnaire (TSQ), the Global Assessment of Functioning scale (GAF) and an assessment scale to address medico-psychological care in emergencies (EUMP). Two patients (3.1%) met the needed criteria for PTSD diagnosis from the TSQ. Among the 56 women evaluated using GAF both as pre and post-test, global functioning was significantly improved by initial post-rape support (50 women (89.3%) had extreme or medium impairment at first post-rape evaluation, and 16 (28.6%) after psychological care; p = 0.04). When interviewed one to two years later, the benefit was fully maintained (16 women (28.6%) presenting extreme or medium impairment).
CONCLUSION
We found the benefits of post-rape psychological support to be present and lasting in this conflict situation. However, we were unable to evaluate all women for the long-term impact, underscoring the difficulty of leading evaluation studies in unstable contexts. Future research is needed to validate these findings in other settings.
背景
在战争和跨文化背景下，人们对心理支持的影响知之甚少，特别是是否存在持久的益处。在这里，我们评估了在刚果共和国布拉柴维尔对遭受强奸的妇女提供的强奸后心理支持的长期影响。
方法
选择参加无国界医生组织在冲突期间在布拉柴维尔开展的性暴力项目的妇女，以评估强奸的心理后果和强奸后心理支持的长期影响。共有 178 名患者符合入选标准：1）年龄大于 15 岁的妇女；2）被身穿军装的不明人员强奸；3）在 2002 年 1 月 1 日至 2003 年 4 月 30 日期间被纳入该项目；和 4）居住在布拉柴维尔。
结果
根据 DSM 标准的初始诊断显示，焦虑障碍（54.1%）和急性应激障碍（24.6%）占主导地位。在最初的心理护理后 1 至 2 年，使用创伤筛查问卷（TSQ）、总体功能评估量表（GAF）和紧急情况下处理医学-心理护理的评估量表（EUMP）对 64 名妇女进行了评估。两名妇女（3.1%）符合 TSQ 诊断 PTSD 的需要标准。在使用 GAF 进行前后评估的 56 名妇女中，最初的强奸后支持显著改善了总体功能（50 名妇女（89.3%）在第一次强奸后评估时存在严重或中度损害，而在心理护理后为 16 名（28.6%）；p=0.04）。一年至两年后接受采访时，获益得以完全维持（16 名妇女（28.6%）表现出严重或中度损害）。
结论
我们发现，在这种冲突情况下，强奸后心理支持具有益处且持久。然而，我们无法评估所有妇女的长期影响，这突出了在不稳定环境中开展评估研究的困难。需要进一步的研究来验证这些发现是否适用于其他环境。
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